叶天士运用人参固本丸经验探析

整理叶天士《临证指南医案》中应用人参固本丸的医案,分析叶氏临床应用人参固本丸的病因病机、症状特点及加减化裁,认为金水相生、培土生金为此方治法要诀,滋阴益气清热是为方之功效,主治肺肾阴虚、肺脾气虚诸证。其拆方思路可拆分为补阴、补气两大用药方向。以滋补肺肾脾为着力点,兼顾涵肝养心,既固气阴之本又清阳亢之热。归纳方证方机,根据临床病证特点,加减药味,改变治疗导向,使治疗诸脏气阴为病之虚劳久疟、内热消渴、风火出血等病证更具针对性,是叶氏运用本方的特色。

Analysis on YE Tianshi's Experience in Applying Renshen Guben Pill

To sort out the medical cases treated by Renshen Guben Pill in YE Tianshi's Case Records as a Guide to Clinical Practice,and analyze the etiology,pathogenesis,characteristics of symptoms,addition and subtraction of Renshen Guben Pill in YE Tianshi's clinical application. YE Tianshi believed that the key treatment methods of this formula were mutual generation between metal and water and banking up earth to generate metal. The effects included:nourishing yin,replenishing qi and clearing heat. It was mainly used in the treatment of lung-kidney yin deficiency and lung-spleen qi deficiency. The formula can be disassembled by two ways:nourishing yin and replenishing qi. The medication should be focused on tonifying the lung,kidney and spleen,as well as nourishing the liver and heart. It can consolidate the root of qi and yin as well as clear the heat due to yang hyperactivity. The syndrome and pathogenesis of the formula are summarized while herbs are added or subtracted according to the clinical symptoms so as to change the treatment orientation,which can make it more suitable for the treatment of diseases due to qi and yin deficiency in zang organs,such as:consumptive disease and chronic malaria,consumptive thirst with internal heat,and hemorrhage of wind-fire,ect. This is the characteristic of YE Tianshi's application of Renshen Guben Pill.